Why the Bay Area has been a tuberculosis hotspot for more than a century

"Alameda, Santa Clara, San Francisco and San Mateo counties each rank among the top 10 in the state when it comes to cases of tuberculosis, or TB, with rates as high as three times the national average. We have a large reservoir of people with (latent tuberculosis infections), and they should be tested and treated. But they're not, for a variety of reasons."

"While cases of tuberculosis are still exceptionally rare compared to developing countries, it reclaimed the title as deadliest infectious disease from COVID-19 in 2023, according to the World Health Organization. The Bay Area has long been an epicenter for the disease on the West Coast because of its ports and as an immigration checkpoint for migrants from places such as Asia and Latin America."

"Currently, U.S. Citizen and Immigrations Services screens migrants for active infections, but those with a dormant strain, known as latent TB, pass through undiscovered. More than 90% of active cases in the Bay Area now occur among immigrants that have come."

Tuberculosis remains a significant public health concern in the Bay Area, particularly in Alameda, Santa Clara, San Francisco, and San Mateo counties, which rank among California's top 10 for TB cases. The region has historically served as an epicenter for tuberculosis on the West Coast due to its ports and role as an immigration checkpoint for migrants from Asia and Latin America. While screening processes exist for active tuberculosis infections, individuals with latent TB infections often go undetected and untreated. The disease reclaimed its status as the deadliest infectious disease globally in 2023, surpassing COVID-19. A recent outbreak affecting over 200 high school students in San Francisco underscores the ongoing public health challenge, highlighting the need for improved testing and treatment of latent infections.

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